Revenue Codes
| 
                                                                     No.  | 
                                                                
                                                                     Revenue Code  | 
                                                                
                                                                     Unit Type  | 
                                                                
                                                                     Revenue Description  | 
                                                            
| 
                                                                     1  | 
                                                                
                                                                     0  | 
                                                                
                                                                     D  | 
                                                                
                                                                     INVALID REVENUE CODE  | 
                                                            
| 
                                                                     2  | 
                                                                
                                                                     001  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TOTAL CHARGE  | 
                                                            
| 
                                                                     3  | 
                                                                
                                                                     020  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     4  | 
                                                                
                                                                     021  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     5  | 
                                                                
                                                                     022  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SNF Resource Utilization Group  | 
                                                            
| 
                                                                     6  | 
                                                                
                                                                     023  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Home Health Resource Group  | 
                                                            
| 
                                                                     7  | 
                                                                
                                                                     024  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IRF Case Mix Group  | 
                                                            
| 
                                                                     8  | 
                                                                
                                                                     025  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     9  | 
                                                                
                                                                     026  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     10  | 
                                                                
                                                                     027  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     11  | 
                                                                
                                                                     028  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     12  | 
                                                                
                                                                     029  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     13  | 
                                                                
                                                                     100  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ALL INCLUSIVE R & B + ANCILLAR  | 
                                                            
| 
                                                                     14  | 
                                                                
                                                                     101  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ALL INCLUSIVE ROOM AND BOARD  | 
                                                            
| 
                                                                     15  | 
                                                                
                                                                     105  | 
                                                                
                                                                     D  | 
                                                                
                                                                     Rev Code for Southcare  | 
                                                            
| 
                                                                     16  | 
                                                                
                                                                     106  | 
                                                                
                                                                     D  | 
                                                                
                                                                     Rev Code for Southcare  | 
                                                            
| 
                                                                     17  | 
                                                                
                                                                     110  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM  | 
                                                            
| 
                                                                     18  | 
                                                                
                                                                     111  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM GYN  | 
                                                            
| 
                                                                     19  | 
                                                                
                                                                     112  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM OB  | 
                                                            
| 
                                                                     20  | 
                                                                
                                                                     113  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM PEDS  | 
                                                            
| 
                                                                     21  | 
                                                                
                                                                     114  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM PSYCH  | 
                                                            
| 
                                                                     22  | 
                                                                
                                                                     115  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM HOSPICE  | 
                                                            
| 
                                                                     23  | 
                                                                
                                                                     116  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM DETOX  | 
                                                            
| 
                                                                     24  | 
                                                                
                                                                     117  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM ONCOLOGY  | 
                                                            
| 
                                                                     25  | 
                                                                
                                                                     118  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM REHAB  | 
                                                            
| 
                                                                     26  | 
                                                                
                                                                     119  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE ROOM OTHER  | 
                                                            
| 
                                                                     27  | 
                                                                
                                                                     120  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM  | 
                                                            
| 
                                                                     28  | 
                                                                
                                                                     121  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM MED/SUR/GYN  | 
                                                            
| 
                                                                     29  | 
                                                                
                                                                     122  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM OB  | 
                                                            
| 
                                                                     30  | 
                                                                
                                                                     123  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM PEDS  | 
                                                            
| 
                                                                     31  | 
                                                                
                                                                     124  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM PSYCH  | 
                                                            
| 
                                                                     32  | 
                                                                
                                                                     125  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM HOSPICE  | 
                                                            
| 
                                                                     33  | 
                                                                
                                                                     126  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM DETOX  | 
                                                            
| 
                                                                     34  | 
                                                                
                                                                     127  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM ONCOLOGY  | 
                                                            
| 
                                                                     35  | 
                                                                
                                                                     128  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM REHAB  | 
                                                            
| 
                                                                     36  | 
                                                                
                                                                     129  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SEMI-PRIVATE ROOM OTHER  | 
                                                            
| 
                                                                     37  | 
                                                                
                                                                     130  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM  | 
                                                            
| 
                                                                     38  | 
                                                                
                                                                     131  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM MED/SUR/GYN  | 
                                                            
| 
                                                                     39  | 
                                                                
                                                                     132  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM OB  | 
                                                            
| 
                                                                     40  | 
                                                                
                                                                     133  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM PEDS  | 
                                                            
| 
                                                                     41  | 
                                                                
                                                                     134  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM PSYCH  | 
                                                            
| 
                                                                     42  | 
                                                                
                                                                     135  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM HOSPICE  | 
                                                            
| 
                                                                     43  | 
                                                                
                                                                     136  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM DETOX  | 
                                                            
| 
                                                                     44  | 
                                                                
                                                                     137  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM ONCOLOGY  | 
                                                            
| 
                                                                     45  | 
                                                                
                                                                     138  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM REHAB  | 
                                                            
| 
                                                                     46  | 
                                                                
                                                                     139  | 
                                                                
                                                                     D  | 
                                                                
                                                                     3/4 BED ROOM OTHER  | 
                                                            
| 
                                                                     47  | 
                                                                
                                                                     140  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM  | 
                                                            
| 
                                                                     48  | 
                                                                
                                                                     141  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM MED/SUR/GY  | 
                                                            
| 
                                                                     49  | 
                                                                
                                                                     142  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM OB  | 
                                                            
| 
                                                                     50  | 
                                                                
                                                                     143  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM PEDS  | 
                                                            
| 
                                                                     51  | 
                                                                
                                                                     144  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM PSYCH  | 
                                                            
| 
                                                                     52  | 
                                                                
                                                                     145  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM HOSPICE  | 
                                                            
| 
                                                                     53  | 
                                                                
                                                                     146  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM DETOX  | 
                                                            
| 
                                                                     54  | 
                                                                
                                                                     147  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM ONCOLOGY  | 
                                                            
| 
                                                                     55  | 
                                                                
                                                                     148  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM REHAB  | 
                                                            
| 
                                                                     56  | 
                                                                
                                                                     149  | 
                                                                
                                                                     D  | 
                                                                
                                                                     PRIVATE DELUXE ROOM OTHER  | 
                                                            
| 
                                                                     57  | 
                                                                
                                                                     150  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED  | 
                                                            
| 
                                                                     58  | 
                                                                
                                                                     151  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED MED/SUR/GYN  | 
                                                            
| 
                                                                     59  | 
                                                                
                                                                     152  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED OB  | 
                                                            
| 
                                                                     60  | 
                                                                
                                                                     153  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED PEDS  | 
                                                            
| 
                                                                     61  | 
                                                                
                                                                     154  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED PSYCH  | 
                                                            
| 
                                                                     62  | 
                                                                
                                                                     155  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED HOSPICE  | 
                                                            
| 
                                                                     63  | 
                                                                
                                                                     156  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED DETOX  | 
                                                            
| 
                                                                     64  | 
                                                                
                                                                     157  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED ONCOLOGY  | 
                                                            
| 
                                                                     65  | 
                                                                
                                                                     158  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED REHAB  | 
                                                            
| 
                                                                     66  | 
                                                                
                                                                     159  | 
                                                                
                                                                     D  | 
                                                                
                                                                     WARD 5-6 BED OTHER  | 
                                                            
| 
                                                                     67  | 
                                                                
                                                                     160  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ROOM & BOARD OTHER  | 
                                                            
| 
                                                                     68  | 
                                                                
                                                                     164  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ISOLATION  | 
                                                            
| 
                                                                     69  | 
                                                                
                                                                     167  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SELF-CARE  | 
                                                            
| 
                                                                     70  | 
                                                                
                                                                     169  | 
                                                                
                                                                     D  | 
                                                                
                                                                     OTHER  | 
                                                            
| 
                                                                     71  | 
                                                                
                                                                     170  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY GENERAL  | 
                                                            
| 
                                                                     72  | 
                                                                
                                                                     171  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY NEWBORN LEVEL I  | 
                                                            
| 
                                                                     73  | 
                                                                
                                                                     172  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY NEWBORN LEVEL II  | 
                                                            
| 
                                                                     74  | 
                                                                
                                                                     173  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY NEWBORN LEVEL III  | 
                                                            
| 
                                                                     75  | 
                                                                
                                                                     174  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY NEWBORN LEVEL IV  | 
                                                            
| 
                                                                     76  | 
                                                                
                                                                     175  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY NEWBORN NICU  | 
                                                            
| 
                                                                     77  | 
                                                                
                                                                     179  | 
                                                                
                                                                     D  | 
                                                                
                                                                     NURSERY BOARDER/OTHER  | 
                                                            
| 
                                                                     78  | 
                                                                
                                                                     180  | 
                                                                
                                                                     D  | 
                                                                
                                                                     LOA  | 
                                                            
| 
                                                                     79  | 
                                                                
                                                                     181  | 
                                                                
                                                                     D  | 
                                                                
                                                                     RESERVED  | 
                                                            
| 
                                                                     80  | 
                                                                
                                                                     182  | 
                                                                
                                                                     D  | 
                                                                
                                                                     LOA/PT CONV  | 
                                                            
| 
                                                                     81  | 
                                                                
                                                                     183  | 
                                                                
                                                                     D  | 
                                                                
                                                                     LOA/THERAPEUTIC  | 
                                                            
| 
                                                                     82  | 
                                                                
                                                                     184  | 
                                                                
                                                                     D  | 
                                                                
                                                                     LOA/ICF/MR  | 
                                                            
| 
                                                                     83  | 
                                                                
                                                                     185  | 
                                                                
                                                                     D  | 
                                                                
                                                                     LOA/NURS HOME  | 
                                                            
| 
                                                                     84  | 
                                                                
                                                                     189  | 
                                                                
                                                                     D  | 
                                                                
                                                                     LOA/OTHER  | 
                                                            
| 
                                                                     85  | 
                                                                
                                                                     190  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SUBACUTE  | 
                                                            
| 
                                                                     86  | 
                                                                
                                                                     191  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SUBACUTE/LEVEL I  | 
                                                            
| 
                                                                     87  | 
                                                                
                                                                     192  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SUBACUTE/LEVEL II  | 
                                                            
| 
                                                                     88  | 
                                                                
                                                                     193  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SUBACUTE/LEVEL III  | 
                                                            
| 
                                                                     89  | 
                                                                
                                                                     194  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SUBACUTE/LEVEL IV  | 
                                                            
| 
                                                                     90  | 
                                                                
                                                                     199  | 
                                                                
                                                                     D  | 
                                                                
                                                                     SUBACUTE/OTHER  | 
                                                            
| 
                                                                     91  | 
                                                                
                                                                     200  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU  | 
                                                            
| 
                                                                     92  | 
                                                                
                                                                     201  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/SURGICAL  | 
                                                            
| 
                                                                     93  | 
                                                                
                                                                     202  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/MEDICAL  | 
                                                            
| 
                                                                     94  | 
                                                                
                                                                     203  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/PEDS  | 
                                                            
| 
                                                                     95  | 
                                                                
                                                                     204  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/PSTAY  | 
                                                            
| 
                                                                     96  | 
                                                                
                                                                     205  | 
                                                                
                                                                     D  | 
                                                                
                                                                     Special Accommodation (Non-MCA)  | 
                                                            
| 
                                                                     97  | 
                                                                
                                                                     206  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/INTERMEDIATE  | 
                                                            
| 
                                                                     98  | 
                                                                
                                                                     207  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/BURN CARE  | 
                                                            
| 
                                                                     99  | 
                                                                
                                                                     208  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/TRAUMA  | 
                                                            
| 
                                                                     100  | 
                                                                
                                                                     209  | 
                                                                
                                                                     D  | 
                                                                
                                                                     ICU/OTHER  | 
                                                            
| 
                                                                     101  | 
                                                                
                                                                     210  | 
                                                                
                                                                     D  | 
                                                                
                                                                     CCU  | 
                                                            
| 
                                                                     102  | 
                                                                
                                                                     211  | 
                                                                
                                                                     D  | 
                                                                
                                                                     CCU/MYO INFARCT  | 
                                                            
| 
                                                                     103  | 
                                                                
                                                                     212  | 
                                                                
                                                                     D  | 
                                                                
                                                                     CCU/PULMONARY  | 
                                                            
| 
                                                                     104  | 
                                                                
                                                                     213  | 
                                                                
                                                                     D  | 
                                                                
                                                                     CCU/TRANSPLANT  | 
                                                            
| 
                                                                     105  | 
                                                                
                                                                     214  | 
                                                                
                                                                     D  | 
                                                                
                                                                     CCU/INTERMEDIATE  | 
                                                            
| 
                                                                     106  | 
                                                                
                                                                     219  | 
                                                                
                                                                     D  | 
                                                                
                                                                     CCU/OTHER  | 
                                                            
| 
                                                                     107  | 
                                                                
                                                                     220  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SPECIAL CHARGES  | 
                                                            
| 
                                                                     108  | 
                                                                
                                                                     221  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ADMIT CHARGE  | 
                                                            
| 
                                                                     109  | 
                                                                
                                                                     222  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TECH SUPPORT CHARGE  | 
                                                            
| 
                                                                     110  | 
                                                                
                                                                     223  | 
                                                                
                                                                     N  | 
                                                                
                                                                     UR CHARGE  | 
                                                            
| 
                                                                     111  | 
                                                                
                                                                     224  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LATE DISCH/MED NEC  | 
                                                            
| 
                                                                     112  | 
                                                                
                                                                     229  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER SPEC CHG  | 
                                                            
| 
                                                                     113  | 
                                                                
                                                                     230  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NURSING INCREM  | 
                                                            
| 
                                                                     114  | 
                                                                
                                                                     231  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUR INCR/NURSERY  | 
                                                            
| 
                                                                     115  | 
                                                                
                                                                     232  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUR INCR/OB  | 
                                                            
| 
                                                                     116  | 
                                                                
                                                                     233  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUR INCR/ICU  | 
                                                            
| 
                                                                     117  | 
                                                                
                                                                     234  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUR INCR/CCU  | 
                                                            
| 
                                                                     118  | 
                                                                
                                                                     235  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUR INCR/HOSPICE  | 
                                                            
| 
                                                                     119  | 
                                                                
                                                                     239  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUR INCR/OTHER  | 
                                                            
| 
                                                                     120  | 
                                                                
                                                                     240  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ALL INCL ANCIL  | 
                                                            
| 
                                                                     121  | 
                                                                
                                                                     241  | 
                                                                
                                                                     N  | 
                                                                
                                                                     All-Inclusive Ancillary, Basic  | 
                                                            
| 
                                                                     122  | 
                                                                
                                                                     242  | 
                                                                
                                                                     N  | 
                                                                
                                                                     All-Inclusive Ancillary, Comp  | 
                                                            
| 
                                                                     123  | 
                                                                
                                                                     243  | 
                                                                
                                                                     N  | 
                                                                
                                                                     All-Inclusive Ancillary, Spec  | 
                                                            
| 
                                                                     124  | 
                                                                
                                                                     249  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ALL INCL ANCIL/OTHER  | 
                                                            
| 
                                                                     125  | 
                                                                
                                                                     250  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PHARMACY  | 
                                                            
| 
                                                                     126  | 
                                                                
                                                                     251  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/GENERIC  | 
                                                            
| 
                                                                     127  | 
                                                                
                                                                     252  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/NONGENERIC  | 
                                                            
| 
                                                                     128  | 
                                                                
                                                                     253  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/TAKEHOME  | 
                                                            
| 
                                                                     129  | 
                                                                
                                                                     254  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/INCIDENT ODX  | 
                                                            
| 
                                                                     130  | 
                                                                
                                                                     255  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/INCIDENT RAD  | 
                                                            
| 
                                                                     131  | 
                                                                
                                                                     256  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/EXPERIMT  | 
                                                            
| 
                                                                     132  | 
                                                                
                                                                     257  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/NONPRESCRIPT  | 
                                                            
| 
                                                                     133  | 
                                                                
                                                                     258  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV SOLUTIONS  | 
                                                            
| 
                                                                     134  | 
                                                                
                                                                     259  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/OTHER  | 
                                                            
| 
                                                                     135  | 
                                                                
                                                                     260  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THERAPY  | 
                                                            
| 
                                                                     136  | 
                                                                
                                                                     261  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THER/INFUSN PUMP  | 
                                                            
| 
                                                                     137  | 
                                                                
                                                                     262  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THER/PHARM/SVC  | 
                                                            
| 
                                                                     138  | 
                                                                
                                                                     263  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THER/DRUGS/SUPPLY/DELV  | 
                                                            
| 
                                                                     139  | 
                                                                
                                                                     264  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THER/SUPPLIES  | 
                                                            
| 
                                                                     140  | 
                                                                
                                                                     269  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THERAPY/OTHER  | 
                                                            
| 
                                                                     141  | 
                                                                
                                                                     270  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED-SUR SUPPLIES  | 
                                                            
| 
                                                                     142  | 
                                                                
                                                                     271  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NON-STER SUPPLY  | 
                                                            
| 
                                                                     143  | 
                                                                
                                                                     272  | 
                                                                
                                                                     N  | 
                                                                
                                                                     STERILE SUPPLY  | 
                                                            
| 
                                                                     144  | 
                                                                
                                                                     273  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TAKEHOME SUPPLY  | 
                                                            
| 
                                                                     145  | 
                                                                
                                                                     274  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PROSTH/ORTH DEV  | 
                                                            
| 
                                                                     146  | 
                                                                
                                                                     275  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PACEMAKER  | 
                                                            
| 
                                                                     147  | 
                                                                
                                                                     276  | 
                                                                
                                                                     N  | 
                                                                
                                                                     INTRA OC LENS  | 
                                                            
| 
                                                                     148  | 
                                                                
                                                                     277  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OXYGEN -TAKE HOME  | 
                                                            
| 
                                                                     149  | 
                                                                
                                                                     278  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SUPPLY/IMPLANTS  | 
                                                            
| 
                                                                     150  | 
                                                                
                                                                     279  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SUPPLY/OTHER  | 
                                                            
| 
                                                                     151  | 
                                                                
                                                                     280  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ONCOLOGY  | 
                                                            
| 
                                                                     152  | 
                                                                
                                                                     289  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ONCOLOGY/OTHER  | 
                                                            
| 
                                                                     153  | 
                                                                
                                                                     290  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED EQUIP/DURAB  | 
                                                            
| 
                                                                     154  | 
                                                                
                                                                     291  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED EQUIP/RENT  | 
                                                            
| 
                                                                     155  | 
                                                                
                                                                     292  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED EQUIP/NEW  | 
                                                            
| 
                                                                     156  | 
                                                                
                                                                     293  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED EQUIP/USED  | 
                                                            
| 
                                                                     157  | 
                                                                
                                                                     294  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED EQUIP/SUPPLIES/DRUGS  | 
                                                            
| 
                                                                     158  | 
                                                                
                                                                     299  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED EQUIP/OTHER  | 
                                                            
| 
                                                                     159  | 
                                                                
                                                                     300  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LABORATORY CLINICAL  | 
                                                            
| 
                                                                     160  | 
                                                                
                                                                     301  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/CHEMISTRY  | 
                                                            
| 
                                                                     161  | 
                                                                
                                                                     302  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/IMMUNOLOGY  | 
                                                            
| 
                                                                     162  | 
                                                                
                                                                     303  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/RENAL HOME  | 
                                                            
| 
                                                                     163  | 
                                                                
                                                                     304  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/NR DIALYSIS  | 
                                                            
| 
                                                                     164  | 
                                                                
                                                                     305  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/HEMATOLOGY  | 
                                                            
| 
                                                                     165  | 
                                                                
                                                                     306  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/BACT-MICRO  | 
                                                            
| 
                                                                     166  | 
                                                                
                                                                     307  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/UROLOGY  | 
                                                            
| 
                                                                     167  | 
                                                                
                                                                     309  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LAB/OTHER  | 
                                                            
| 
                                                                     168  | 
                                                                
                                                                     310  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PATHOLOGY LAB  | 
                                                            
| 
                                                                     169  | 
                                                                
                                                                     311  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PATHOL/CYTOLOGY  | 
                                                            
| 
                                                                     170  | 
                                                                
                                                                     312  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PATHOL/HYSTOL  | 
                                                            
| 
                                                                     171  | 
                                                                
                                                                     314  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PATHOL/BIOPSY  | 
                                                            
| 
                                                                     172  | 
                                                                
                                                                     319  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PATHOL/OTHER  | 
                                                            
| 
                                                                     173  | 
                                                                
                                                                     320  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RADIOLOGY DIAGNOSTIC  | 
                                                            
| 
                                                                     174  | 
                                                                
                                                                     321  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DX X-RAY/ANGIO  | 
                                                            
| 
                                                                     175  | 
                                                                
                                                                     322  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DX X-RAY/ARTH  | 
                                                            
| 
                                                                     176  | 
                                                                
                                                                     323  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DX X-RAY/ARTER  | 
                                                            
| 
                                                                     177  | 
                                                                
                                                                     324  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DX X-RAY/CHEST  | 
                                                            
| 
                                                                     178  | 
                                                                
                                                                     329  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DX X-RAY/OTHER  | 
                                                            
| 
                                                                     179  | 
                                                                
                                                                     330  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RX X-RAY  | 
                                                            
| 
                                                                     180  | 
                                                                
                                                                     331  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CHEMOTHER/INJ  | 
                                                            
| 
                                                                     181  | 
                                                                
                                                                     332  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CHEMOTHER/ORAL  | 
                                                            
| 
                                                                     182  | 
                                                                
                                                                     333  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RADIATION THERAPY  | 
                                                            
| 
                                                                     183  | 
                                                                
                                                                     335  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CHEMOTHERP-IV  | 
                                                            
| 
                                                                     184  | 
                                                                
                                                                     339  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RX X-RAY/OTHER  | 
                                                            
| 
                                                                     185  | 
                                                                
                                                                     340  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUCLEAR MEDICINE  | 
                                                            
| 
                                                                     186  | 
                                                                
                                                                     341  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUCLEAR MED/DX  | 
                                                            
| 
                                                                     187  | 
                                                                
                                                                     342  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUCLEAR MED/RX  | 
                                                            
| 
                                                                     188  | 
                                                                
                                                                     349  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NUCLEAR MED/OTHER  | 
                                                            
| 
                                                                     189  | 
                                                                
                                                                     350  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CT SCAN  | 
                                                            
| 
                                                                     190  | 
                                                                
                                                                     351  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CT SCAN/HEAD  | 
                                                            
| 
                                                                     191  | 
                                                                
                                                                     352  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CT SCAN/BODY  | 
                                                            
| 
                                                                     192  | 
                                                                
                                                                     359  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CT SCAN/OTHER  | 
                                                            
| 
                                                                     193  | 
                                                                
                                                                     360  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OR SERVICES  | 
                                                            
| 
                                                                     194  | 
                                                                
                                                                     361  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OR/MINOR  | 
                                                            
| 
                                                                     195  | 
                                                                
                                                                     362  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OR/ORGAN TRANS  | 
                                                            
| 
                                                                     196  | 
                                                                
                                                                     367  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OR/KIDNEY TRANS  | 
                                                            
| 
                                                                     197  | 
                                                                
                                                                     369  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OR/OTHER  | 
                                                            
| 
                                                                     198  | 
                                                                
                                                                     370  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ANESTHESIA  | 
                                                            
| 
                                                                     199  | 
                                                                
                                                                     371  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ANESTHES/INCIDENT RAD  | 
                                                            
| 
                                                                     200  | 
                                                                
                                                                     372  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ANESTHES/INCDNT OTHER DX  | 
                                                            
| 
                                                                     201  | 
                                                                
                                                                     374  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ANESTHES/ACUPUNC  | 
                                                            
| 
                                                                     202  | 
                                                                
                                                                     379  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ANESTHES/OTHER  | 
                                                            
| 
                                                                     203  | 
                                                                
                                                                     380  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD  | 
                                                            
| 
                                                                     204  | 
                                                                
                                                                     381  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/PKD RED  | 
                                                            
| 
                                                                     205  | 
                                                                
                                                                     382  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/WHOLE  | 
                                                            
| 
                                                                     206  | 
                                                                
                                                                     383  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/PLASMA  | 
                                                            
| 
                                                                     207  | 
                                                                
                                                                     384  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/PLATELETS  | 
                                                            
| 
                                                                     208  | 
                                                                
                                                                     385  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/LEUCOCYTES  | 
                                                            
| 
                                                                     209  | 
                                                                
                                                                     386  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/COMPONENTS  | 
                                                            
| 
                                                                     210  | 
                                                                
                                                                     387  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/DERIVIATIVES  | 
                                                            
| 
                                                                     211  | 
                                                                
                                                                     389  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/OTHER  | 
                                                            
| 
                                                                     212  | 
                                                                
                                                                     390  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/STOR-PROC  | 
                                                            
| 
                                                                     213  | 
                                                                
                                                                     391  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/ADMIN  | 
                                                            
| 
                                                                     214  | 
                                                                
                                                                     399  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BLOOD/OTHER  | 
                                                            
| 
                                                                     215  | 
                                                                
                                                                     400  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IMAGE SERVICE  | 
                                                            
| 
                                                                     216  | 
                                                                
                                                                     401  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIAG MAMMOGRAPHY  | 
                                                            
| 
                                                                     217  | 
                                                                
                                                                     402  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ULTRASOUND  | 
                                                            
| 
                                                                     218  | 
                                                                
                                                                     403  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SCRN MAMMOGRAPHY  | 
                                                            
| 
                                                                     219  | 
                                                                
                                                                     404  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PET SCAN  | 
                                                            
| 
                                                                     220  | 
                                                                
                                                                     409  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER IMAG SVS  | 
                                                            
| 
                                                                     221  | 
                                                                
                                                                     410  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESPIRATORY SERVICES  | 
                                                            
| 
                                                                     222  | 
                                                                
                                                                     412  | 
                                                                
                                                                     N  | 
                                                                
                                                                     INHALATION SVC  | 
                                                            
| 
                                                                     223  | 
                                                                
                                                                     413  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HYPERBARIC O2  | 
                                                            
| 
                                                                     224  | 
                                                                
                                                                     419  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER RESPIR SVS  | 
                                                            
| 
                                                                     225  | 
                                                                
                                                                     420  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PHYSICAL THERAPY  | 
                                                            
| 
                                                                     226  | 
                                                                
                                                                     421  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PHYS THERP/VISIT  | 
                                                            
| 
                                                                     227  | 
                                                                
                                                                     422  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PHYS THERP/HOUR  | 
                                                            
| 
                                                                     228  | 
                                                                
                                                                     423  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PHYS THERP/GROUP  | 
                                                            
| 
                                                                     229  | 
                                                                
                                                                     424  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PHYS THERP/EVAL  | 
                                                            
| 
                                                                     230  | 
                                                                
                                                                     429  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER PHYS THERP  | 
                                                            
| 
                                                                     231  | 
                                                                
                                                                     430  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OCCUPATIONAL THERAPY  | 
                                                            
| 
                                                                     232  | 
                                                                
                                                                     431  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OCCUP THERP/VISIT  | 
                                                            
| 
                                                                     233  | 
                                                                
                                                                     432  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OCCUP THERP/HOUR  | 
                                                            
| 
                                                                     234  | 
                                                                
                                                                     433  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OCCUP THERP/GROUP  | 
                                                            
| 
                                                                     235  | 
                                                                
                                                                     434  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OCCUP THERP/EVAL  | 
                                                            
| 
                                                                     236  | 
                                                                
                                                                     439  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER OCCUP THERP  | 
                                                            
| 
                                                                     237  | 
                                                                
                                                                     440  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SPEECH PATHOL  | 
                                                            
| 
                                                                     238  | 
                                                                
                                                                     441  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SPEECH PATH/VISIT  | 
                                                            
| 
                                                                     239  | 
                                                                
                                                                     442  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SPEECH PATH/HOUR  | 
                                                            
| 
                                                                     240  | 
                                                                
                                                                     443  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SPEECH PATH/GROUP  | 
                                                            
| 
                                                                     241  | 
                                                                
                                                                     444  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SPEECH PATH/EVAL  | 
                                                            
| 
                                                                     242  | 
                                                                
                                                                     449  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER SPEECH PAT  | 
                                                            
| 
                                                                     243  | 
                                                                
                                                                     450  | 
                                                                
                                                                     N  | 
                                                                
                                                                     EMERGENCY ROOM  | 
                                                            
| 
                                                                     244  | 
                                                                
                                                                     451  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ER/EMTALA  | 
                                                            
| 
                                                                     245  | 
                                                                
                                                                     452  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ER/BEYOND EMTALA  | 
                                                            
| 
                                                                     246  | 
                                                                
                                                                     456  | 
                                                                
                                                                     N  | 
                                                                
                                                                     URGENT CARE  | 
                                                            
| 
                                                                     247  | 
                                                                
                                                                     459  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER EMER ROOM  | 
                                                            
| 
                                                                     248  | 
                                                                
                                                                     460  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PULMONARY FUNC  | 
                                                            
| 
                                                                     249  | 
                                                                
                                                                     469  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER PULMONARY FUNC  | 
                                                            
| 
                                                                     250  | 
                                                                
                                                                     470  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AUDIOLOGY  | 
                                                            
| 
                                                                     251  | 
                                                                
                                                                     471  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AUDIOLOGY/DX  | 
                                                            
| 
                                                                     252  | 
                                                                
                                                                     472  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AUDIOLOGY/RX  | 
                                                            
| 
                                                                     253  | 
                                                                
                                                                     479  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER AUDIOLOGY  | 
                                                            
| 
                                                                     254  | 
                                                                
                                                                     480  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CARDIOLOGY  | 
                                                            
| 
                                                                     255  | 
                                                                
                                                                     481  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CARDIAC CATH LAB  | 
                                                            
| 
                                                                     256  | 
                                                                
                                                                     482  | 
                                                                
                                                                     N  | 
                                                                
                                                                     STRESS TEST  | 
                                                            
| 
                                                                     257  | 
                                                                
                                                                     483  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ECHOCARDIOLOGY  | 
                                                            
| 
                                                                     258  | 
                                                                
                                                                     489  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER CARDIOL  | 
                                                            
| 
                                                                     259  | 
                                                                
                                                                     490  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL SURG  | 
                                                            
| 
                                                                     260  | 
                                                                
                                                                     499  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER AMBL SURG  | 
                                                            
| 
                                                                     261  | 
                                                                
                                                                     500  | 
                                                                
                                                                     H  | 
                                                                
                                                                     OUTPATIENT SVS  | 
                                                            
| 
                                                                     262  | 
                                                                
                                                                     509  | 
                                                                
                                                                     H  | 
                                                                
                                                                     OUTPATIENT/OTHER  | 
                                                            
| 
                                                                     263  | 
                                                                
                                                                     510  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CLINIC  | 
                                                            
| 
                                                                     264  | 
                                                                
                                                                     511  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CHRONIC PAIN CL  | 
                                                            
| 
                                                                     265  | 
                                                                
                                                                     512  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DENTAL CLINIC  | 
                                                            
| 
                                                                     266  | 
                                                                
                                                                     513  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH CLINIC  | 
                                                            
| 
                                                                     267  | 
                                                                
                                                                     514  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OB-GYN CLINIC  | 
                                                            
| 
                                                                     268  | 
                                                                
                                                                     515  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PEDS CLINIC  | 
                                                            
| 
                                                                     269  | 
                                                                
                                                                     516  | 
                                                                
                                                                     N  | 
                                                                
                                                                     URGENT CLINIC  | 
                                                            
| 
                                                                     270  | 
                                                                
                                                                     517  | 
                                                                
                                                                     N  | 
                                                                
                                                                     FAMILY CLINIC  | 
                                                            
| 
                                                                     271  | 
                                                                
                                                                     519  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER CLINIC  | 
                                                            
| 
                                                                     272  | 
                                                                
                                                                     520  | 
                                                                
                                                                     N  | 
                                                                
                                                                     FREESTAND CLINIC  | 
                                                            
| 
                                                                     273  | 
                                                                
                                                                     521  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RURAL/CLINIC  | 
                                                            
| 
                                                                     274  | 
                                                                
                                                                     522  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RURAL/HOME  | 
                                                            
| 
                                                                     275  | 
                                                                
                                                                     523  | 
                                                                
                                                                     N  | 
                                                                
                                                                     FR/STD FAMILY CLINIC  | 
                                                            
| 
                                                                     276  | 
                                                                
                                                                     526  | 
                                                                
                                                                     N  | 
                                                                
                                                                     FR STD URGENT CLINIC  | 
                                                            
| 
                                                                     277  | 
                                                                
                                                                     529  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER FR/STD CLINIC  | 
                                                            
| 
                                                                     278  | 
                                                                
                                                                     530  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OSTEOPATH SVS  | 
                                                            
| 
                                                                     279  | 
                                                                
                                                                     531  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OSTEOPATH RX  | 
                                                            
| 
                                                                     280  | 
                                                                
                                                                     539  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER OSTEOPATH  | 
                                                            
| 
                                                                     281  | 
                                                                
                                                                     540  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBULANCE  | 
                                                            
| 
                                                                     282  | 
                                                                
                                                                     541  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/SUPPLY  | 
                                                            
| 
                                                                     283  | 
                                                                
                                                                     542  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/MED TRANS  | 
                                                            
| 
                                                                     284  | 
                                                                
                                                                     543  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/HEARTMOBL  | 
                                                            
| 
                                                                     285  | 
                                                                
                                                                     544  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/OXY  | 
                                                            
| 
                                                                     286  | 
                                                                
                                                                     545  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AIR AMBULANCE  | 
                                                            
| 
                                                                     287  | 
                                                                
                                                                     546  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/NEONAT  | 
                                                            
| 
                                                                     288  | 
                                                                
                                                                     547  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/PHARMACY  | 
                                                            
| 
                                                                     289  | 
                                                                
                                                                     548  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AMBUL/TELEPHONIC EKG  | 
                                                            
| 
                                                                     290  | 
                                                                
                                                                     549  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER AMBULANCE  | 
                                                            
| 
                                                                     291  | 
                                                                
                                                                     550  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SKILLED NURSING  | 
                                                            
| 
                                                                     292  | 
                                                                
                                                                     551  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SKILLED NURS/VISIT  | 
                                                            
| 
                                                                     293  | 
                                                                
                                                                     552  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SKILLED NURS/HOUR  | 
                                                            
| 
                                                                     294  | 
                                                                
                                                                     559  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SKILLED NURS/OTHER  | 
                                                            
| 
                                                                     295  | 
                                                                
                                                                     560  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED SOCIAL SVS  | 
                                                            
| 
                                                                     296  | 
                                                                
                                                                     561  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED SOCIAL SERVS/VISIT  | 
                                                            
| 
                                                                     297  | 
                                                                
                                                                     562  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED SOCIAL SERVS/HOUR  | 
                                                            
| 
                                                                     298  | 
                                                                
                                                                     569  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED SOCIAL SERVS/OTHER  | 
                                                            
| 
                                                                     299  | 
                                                                
                                                                     570  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AIDE/HOME HEALTH  | 
                                                            
| 
                                                                     300  | 
                                                                
                                                                     571  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AIDE/HOME HEALTH/VISIT  | 
                                                            
| 
                                                                     301  | 
                                                                
                                                                     572  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AIDE/HOME HEALTH/HOUR  | 
                                                            
| 
                                                                     302  | 
                                                                
                                                                     579  | 
                                                                
                                                                     N  | 
                                                                
                                                                     AIDE/HOME HEALTH/OTHER  | 
                                                            
| 
                                                                     303  | 
                                                                
                                                                     580  | 
                                                                
                                                                     N  | 
                                                                
                                                                     VISIT/HOME HEALTH  | 
                                                            
| 
                                                                     304  | 
                                                                
                                                                     581  | 
                                                                
                                                                     N  | 
                                                                
                                                                     VISIT/HOME HLTH/VISIT  | 
                                                            
| 
                                                                     305  | 
                                                                
                                                                     582  | 
                                                                
                                                                     N  | 
                                                                
                                                                     VISIT/HOME HLTH/HOUR  | 
                                                            
| 
                                                                     306  | 
                                                                
                                                                     583  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HH-Assessment  | 
                                                            
| 
                                                                     307  | 
                                                                
                                                                     589  | 
                                                                
                                                                     N  | 
                                                                
                                                                     VISIT/HOME HLTH/OTHER  | 
                                                            
| 
                                                                     308  | 
                                                                
                                                                     590  | 
                                                                
                                                                     N  | 
                                                                
                                                                     UNIT/HOME HEALTH  | 
                                                            
| 
                                                                     309  | 
                                                                
                                                                     599  | 
                                                                
                                                                     N  | 
                                                                
                                                                     UNIT/HOME HLTH/OTHER  | 
                                                            
| 
                                                                     310  | 
                                                                
                                                                     600  | 
                                                                
                                                                     N  | 
                                                                
                                                                     O2/HOME HEALTH  | 
                                                            
| 
                                                                     311  | 
                                                                
                                                                     601  | 
                                                                
                                                                     N  | 
                                                                
                                                                     O2/STAT/EQUIP/SUPPL/CONT  | 
                                                            
| 
                                                                     312  | 
                                                                
                                                                     602  | 
                                                                
                                                                     N  | 
                                                                
                                                                     O2/STAT/EQUIP/UNDER 1 LPM  | 
                                                            
| 
                                                                     313  | 
                                                                
                                                                     603  | 
                                                                
                                                                     N  | 
                                                                
                                                                     O2/STAT/EQUIP/OVER 4 LPM  | 
                                                            
| 
                                                                     314  | 
                                                                
                                                                     604  | 
                                                                
                                                                     N  | 
                                                                
                                                                     O2/PORTABLE ADD-ON  | 
                                                            
| 
                                                                     315  | 
                                                                
                                                                     609  | 
                                                                
                                                                     N  | 
                                                                
                                                                     O2/OTHER  | 
                                                            
| 
                                                                     316  | 
                                                                
                                                                     610  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRT  | 
                                                            
| 
                                                                     317  | 
                                                                
                                                                     611  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRI-BRAIN  | 
                                                            
| 
                                                                     318  | 
                                                                
                                                                     612  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRI-SPINE  | 
                                                            
| 
                                                                     319  | 
                                                                
                                                                     613  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESERVED  | 
                                                            
| 
                                                                     320  | 
                                                                
                                                                     614  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRI-OTHER  | 
                                                            
| 
                                                                     321  | 
                                                                
                                                                     615  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRA-HEAD AND NECK  | 
                                                            
| 
                                                                     322  | 
                                                                
                                                                     616  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRA-LOWER EXT  | 
                                                            
| 
                                                                     323  | 
                                                                
                                                                     617  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESERVED  | 
                                                            
| 
                                                                     324  | 
                                                                
                                                                     618  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRA-OTHER  | 
                                                            
| 
                                                                     325  | 
                                                                
                                                                     619  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MRT-OTHER  | 
                                                            
| 
                                                                     326  | 
                                                                
                                                                     621  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED-SUR SUPP/INCIDENT RAD  | 
                                                            
| 
                                                                     327  | 
                                                                
                                                                     622  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MED-SUR SUPP/INCIDENT ODX  | 
                                                            
| 
                                                                     328  | 
                                                                
                                                                     623  | 
                                                                
                                                                     N  | 
                                                                
                                                                     SURG DRESSING  | 
                                                            
| 
                                                                     329  | 
                                                                
                                                                     624  | 
                                                                
                                                                     N  | 
                                                                
                                                                     FDA INVEST DEVICE  | 
                                                            
| 
                                                                     330  | 
                                                                
                                                                     630  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESERVED  | 
                                                            
| 
                                                                     331  | 
                                                                
                                                                     631  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUG/SNGL  | 
                                                            
| 
                                                                     332  | 
                                                                
                                                                     632  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUG/MULT  | 
                                                            
| 
                                                                     333  | 
                                                                
                                                                     633  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUG/RSTR  | 
                                                            
| 
                                                                     334  | 
                                                                
                                                                     634  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUG/EPO <= 10,000 UNITS  | 
                                                            
| 
                                                                     335  | 
                                                                
                                                                     635  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUG/EPO >= 10,000 UNITS  | 
                                                            
| 
                                                                     336  | 
                                                                
                                                                     636  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/DETAIL CODE  | 
                                                            
| 
                                                                     337  | 
                                                                
                                                                     637  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUGS/SELF ADMIN  | 
                                                            
| 
                                                                     338  | 
                                                                
                                                                     640  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV THERAPY SVC  | 
                                                            
| 
                                                                     339  | 
                                                                
                                                                     641  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NON RT NURSING/CENTRAL  | 
                                                            
| 
                                                                     340  | 
                                                                
                                                                     642  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV SITE CARE/CENTRAL  | 
                                                            
| 
                                                                     341  | 
                                                                
                                                                     643  | 
                                                                
                                                                     N  | 
                                                                
                                                                     IV STRT/CHNG/PERIPHAL  | 
                                                            
| 
                                                                     342  | 
                                                                
                                                                     644  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NON RT NURSING/PERIPHRL  | 
                                                            
| 
                                                                     343  | 
                                                                
                                                                     645  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TRNG PT/CAREGVR/CENTRAL  | 
                                                            
| 
                                                                     344  | 
                                                                
                                                                     646  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TRNG DSBLPT/CENTRAL  | 
                                                            
| 
                                                                     345  | 
                                                                
                                                                     647  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TRNG/PT/CARGVR/PERIPHRL  | 
                                                            
| 
                                                                     346  | 
                                                                
                                                                     648  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TRNG DSBLPAT/PERIPHRL  | 
                                                            
| 
                                                                     347  | 
                                                                
                                                                     649  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER IV THERAPY SVC  | 
                                                            
| 
                                                                     348  | 
                                                                
                                                                     650  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE  | 
                                                            
| 
                                                                     349  | 
                                                                
                                                                     651  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE/RTN HOME  | 
                                                            
| 
                                                                     350  | 
                                                                
                                                                     652  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE/CTNS/HOME  | 
                                                            
| 
                                                                     351  | 
                                                                
                                                                     653  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESERVED  | 
                                                            
| 
                                                                     352  | 
                                                                
                                                                     654  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESERVED  | 
                                                            
| 
                                                                     353  | 
                                                                
                                                                     655  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE/IP RESPITE  | 
                                                            
| 
                                                                     354  | 
                                                                
                                                                     656  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE/IP NON-RESPITE  | 
                                                            
| 
                                                                     355  | 
                                                                
                                                                     657  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE/PHYSICIAN  | 
                                                            
| 
                                                                     356  | 
                                                                
                                                                     658  | 
                                                                
                                                                     D  | 
                                                                
                                                                     Hospice R&B, Nursing Fac  | 
                                                            
| 
                                                                     357  | 
                                                                
                                                                     659  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOSPICE/OTHER  | 
                                                            
| 
                                                                     358  | 
                                                                
                                                                     660  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESPITE CARE  | 
                                                            
| 
                                                                     359  | 
                                                                
                                                                     661  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESPITE/SKILLED NURSE  | 
                                                            
| 
                                                                     360  | 
                                                                
                                                                     662  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESPITE/HMEAID/HMEMKR  | 
                                                            
| 
                                                                     361  | 
                                                                
                                                                     663  | 
                                                                
                                                                     D  | 
                                                                
                                                                     Respite Care, Daily  | 
                                                            
| 
                                                                     362  | 
                                                                
                                                                     669  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RESPITE OTHER  | 
                                                            
| 
                                                                     363  | 
                                                                
                                                                     670  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OP SPEC RES  | 
                                                            
| 
                                                                     364  | 
                                                                
                                                                     671  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OP SPEC RES/HOSP BASED  | 
                                                            
| 
                                                                     365  | 
                                                                
                                                                     672  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OP SPEC RES/CONTRACTED  | 
                                                            
| 
                                                                     366  | 
                                                                
                                                                     679  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OP SPEC RES/OTHER  | 
                                                            
| 
                                                                     367  | 
                                                                
                                                                     680  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Not Used  | 
                                                            
| 
                                                                     368  | 
                                                                
                                                                     681  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Trauma Level I  | 
                                                            
| 
                                                                     369  | 
                                                                
                                                                     682  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Trauma, Level II  | 
                                                            
| 
                                                                     370  | 
                                                                
                                                                     683  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Trauma, Level III  | 
                                                            
| 
                                                                     371  | 
                                                                
                                                                     684  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Trauma, Level IV  | 
                                                            
| 
                                                                     372  | 
                                                                
                                                                     689  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Trauma, Other  | 
                                                            
| 
                                                                     373  | 
                                                                
                                                                     700  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAST ROOM  | 
                                                            
| 
                                                                     374  | 
                                                                
                                                                     709  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER CAST ROOM  | 
                                                            
| 
                                                                     375  | 
                                                                
                                                                     710  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RECOVERY ROOM  | 
                                                            
| 
                                                                     376  | 
                                                                
                                                                     719  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER RECOV RM  | 
                                                            
| 
                                                                     377  | 
                                                                
                                                                     720  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DELIVEROOM/LABOR  | 
                                                            
| 
                                                                     378  | 
                                                                
                                                                     721  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LABOR  | 
                                                            
| 
                                                                     379  | 
                                                                
                                                                     722  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DELIVERY ROOM  | 
                                                            
| 
                                                                     380  | 
                                                                
                                                                     723  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CIRCUMCISION  | 
                                                            
| 
                                                                     381  | 
                                                                
                                                                     724  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BIRTHING CENTER  | 
                                                            
| 
                                                                     382  | 
                                                                
                                                                     729  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER/DELIV-LABOR  | 
                                                            
| 
                                                                     383  | 
                                                                
                                                                     730  | 
                                                                
                                                                     N  | 
                                                                
                                                                     EKG/ECG  | 
                                                            
| 
                                                                     384  | 
                                                                
                                                                     731  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOLTER MONT  | 
                                                            
| 
                                                                     385  | 
                                                                
                                                                     732  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TELEMETRY  | 
                                                            
| 
                                                                     386  | 
                                                                
                                                                     739  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER EKG/ECG  | 
                                                            
| 
                                                                     387  | 
                                                                
                                                                     740  | 
                                                                
                                                                     N  | 
                                                                
                                                                     EEG  | 
                                                            
| 
                                                                     388  | 
                                                                
                                                                     741  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER EEG  | 
                                                            
| 
                                                                     389  | 
                                                                
                                                                     749  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Other EEG  | 
                                                            
| 
                                                                     390  | 
                                                                
                                                                     750  | 
                                                                
                                                                     N  | 
                                                                
                                                                     GASTR-INST SVS  | 
                                                            
| 
                                                                     391  | 
                                                                
                                                                     759  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER GASTRO-INTS  | 
                                                            
| 
                                                                     392  | 
                                                                
                                                                     760  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TREATMENT/OBSERVATION RM  | 
                                                            
| 
                                                                     393  | 
                                                                
                                                                     761  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TREATMENT RM  | 
                                                            
| 
                                                                     394  | 
                                                                
                                                                     762  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OBSERVATION RM  | 
                                                            
| 
                                                                     395  | 
                                                                
                                                                     769  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER TREAT/OBSERV RM  | 
                                                            
| 
                                                                     396  | 
                                                                
                                                                     770  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PREVENT CARE SVS  | 
                                                            
| 
                                                                     397  | 
                                                                
                                                                     771  | 
                                                                
                                                                     N  | 
                                                                
                                                                     VACCINE ADMIN  | 
                                                            
| 
                                                                     398  | 
                                                                
                                                                     779  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER PREVENT  | 
                                                            
| 
                                                                     399  | 
                                                                
                                                                     780  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TELEMEDICINE  | 
                                                            
| 
                                                                     400  | 
                                                                
                                                                     789  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TELEMEDICINE/OTHER  | 
                                                            
| 
                                                                     401  | 
                                                                
                                                                     790  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LITHOTRIPSY  | 
                                                            
| 
                                                                     402  | 
                                                                
                                                                     799  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LITHOTRIPSY/OTHER  | 
                                                            
| 
                                                                     403  | 
                                                                
                                                                     800  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RENAL DIALYSIS  | 
                                                            
| 
                                                                     404  | 
                                                                
                                                                     801  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/INPT  | 
                                                            
| 
                                                                     405  | 
                                                                
                                                                     802  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/INPT/PER  | 
                                                            
| 
                                                                     406  | 
                                                                
                                                                     803  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/INPT/CAPD  | 
                                                            
| 
                                                                     407  | 
                                                                
                                                                     804  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/INPT/CCPD  | 
                                                            
| 
                                                                     408  | 
                                                                
                                                                     809  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/INPT/OTHER  | 
                                                            
| 
                                                                     409  | 
                                                                
                                                                     810  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ORGAN ACQUISITION  | 
                                                            
| 
                                                                     410  | 
                                                                
                                                                     811  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LIVING DONOR  | 
                                                            
| 
                                                                     411  | 
                                                                
                                                                     812  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CADAVER DONOR  | 
                                                            
| 
                                                                     412  | 
                                                                
                                                                     813  | 
                                                                
                                                                     N  | 
                                                                
                                                                     UNKNOWN DONOR  | 
                                                            
| 
                                                                     413  | 
                                                                
                                                                     814  | 
                                                                
                                                                     N  | 
                                                                
                                                                     UNSUCCESSFUL SEARCH  | 
                                                            
| 
                                                                     414  | 
                                                                
                                                                     819  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER DONOR  | 
                                                            
| 
                                                                     415  | 
                                                                
                                                                     820  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/OP OR HOME  | 
                                                            
| 
                                                                     416  | 
                                                                
                                                                     821  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/COMPOSITE  | 
                                                            
| 
                                                                     417  | 
                                                                
                                                                     822  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/HOME/SUPPL  | 
                                                            
| 
                                                                     418  | 
                                                                
                                                                     823  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/HOME/EQUIP  | 
                                                            
| 
                                                                     419  | 
                                                                
                                                                     824  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/HOME/100%  | 
                                                            
| 
                                                                     420  | 
                                                                
                                                                     825  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/HOME/SUPSERV  | 
                                                            
| 
                                                                     421  | 
                                                                
                                                                     829  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HEMO/HOME/OTHER  | 
                                                            
| 
                                                                     422  | 
                                                                
                                                                     830  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERITONEAL/OP OR HOME  | 
                                                            
| 
                                                                     423  | 
                                                                
                                                                     831  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERTNL/COMPOSITE  | 
                                                            
| 
                                                                     424  | 
                                                                
                                                                     832  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERTNL/HOME/SUPPL  | 
                                                            
| 
                                                                     425  | 
                                                                
                                                                     833  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERTNL/HOME/EQUIP  | 
                                                            
| 
                                                                     426  | 
                                                                
                                                                     834  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERTNL/HOME/100%  | 
                                                            
| 
                                                                     427  | 
                                                                
                                                                     835  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERTNL/HOME/SUPSERV  | 
                                                            
| 
                                                                     428  | 
                                                                
                                                                     839  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERTNL/HOME/OTHER  | 
                                                            
| 
                                                                     429  | 
                                                                
                                                                     840  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/OP OR HOME  | 
                                                            
| 
                                                                     430  | 
                                                                
                                                                     841  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/COMPOSITE  | 
                                                            
| 
                                                                     431  | 
                                                                
                                                                     842  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/HOME/SUPPL  | 
                                                            
| 
                                                                     432  | 
                                                                
                                                                     843  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/HOME/EQUIP  | 
                                                            
| 
                                                                     433  | 
                                                                
                                                                     844  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/HOME/100%  | 
                                                            
| 
                                                                     434  | 
                                                                
                                                                     845  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/HOME/SUPSERV  | 
                                                            
| 
                                                                     435  | 
                                                                
                                                                     849  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAPD/HOME/OTHER  | 
                                                            
| 
                                                                     436  | 
                                                                
                                                                     850  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/OP OR HOME  | 
                                                            
| 
                                                                     437  | 
                                                                
                                                                     851  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/COMPOSITE  | 
                                                            
| 
                                                                     438  | 
                                                                
                                                                     852  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/HOME/SUPPL  | 
                                                            
| 
                                                                     439  | 
                                                                
                                                                     853  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/HOME/EQUIP  | 
                                                            
| 
                                                                     440  | 
                                                                
                                                                     854  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/HOME/100%  | 
                                                            
| 
                                                                     441  | 
                                                                
                                                                     855  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/HOME/SUPSERV  | 
                                                            
| 
                                                                     442  | 
                                                                
                                                                     859  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CCPD/HOME/OTHER  | 
                                                            
| 
                                                                     443  | 
                                                                
                                                                     880  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/MISC  | 
                                                            
| 
                                                                     444  | 
                                                                
                                                                     881  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/ULTRAFILT  | 
                                                            
| 
                                                                     445  | 
                                                                
                                                                     882  | 
                                                                
                                                                     N  | 
                                                                
                                                                     HOME DIALYSIS AID VISIT  | 
                                                            
| 
                                                                     446  | 
                                                                
                                                                     889  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DIALY/MISC/OTHER  | 
                                                            
| 
                                                                     447  | 
                                                                
                                                                     900  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH TREATMENT  | 
                                                            
| 
                                                                     448  | 
                                                                
                                                                     901  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ELECTRO SHOCK  | 
                                                            
| 
                                                                     449  | 
                                                                
                                                                     902  | 
                                                                
                                                                     N  | 
                                                                
                                                                     MILIEU THERAPY  | 
                                                            
| 
                                                                     450  | 
                                                                
                                                                     903  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PLAY THERAPY  | 
                                                            
| 
                                                                     451  | 
                                                                
                                                                     904  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ACTIVITY THERAPY  | 
                                                            
| 
                                                                     452  | 
                                                                
                                                                     909  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER PSYCH RX  | 
                                                            
| 
                                                                     453  | 
                                                                
                                                                     910  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH SERVICES  | 
                                                            
| 
                                                                     454  | 
                                                                
                                                                     911  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/REHAB  | 
                                                            
| 
                                                                     455  | 
                                                                
                                                                     912  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/PARTIAL HOSP  | 
                                                            
| 
                                                                     456  | 
                                                                
                                                                     913  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/PARTIAL INTENSIVE  | 
                                                            
| 
                                                                     457  | 
                                                                
                                                                     914  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/INDIV RX  | 
                                                            
| 
                                                                     458  | 
                                                                
                                                                     915  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/GROUP RX  | 
                                                            
| 
                                                                     459  | 
                                                                
                                                                     916  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/ FAMILY RX  | 
                                                            
| 
                                                                     460  | 
                                                                
                                                                     917  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/BIOFEED  | 
                                                            
| 
                                                                     461  | 
                                                                
                                                                     918  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/TESTING  | 
                                                            
| 
                                                                     462  | 
                                                                
                                                                     919  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PSYCH/OTHER  | 
                                                            
| 
                                                                     463  | 
                                                                
                                                                     920  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER DIAGNOSTIC SERVICES  | 
                                                            
| 
                                                                     464  | 
                                                                
                                                                     921  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PERI VASCUL LAB  | 
                                                            
| 
                                                                     465  | 
                                                                
                                                                     922  | 
                                                                
                                                                     N  | 
                                                                
                                                                     EMG  | 
                                                            
| 
                                                                     466  | 
                                                                
                                                                     923  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PAP SMEAR  | 
                                                            
| 
                                                                     467  | 
                                                                
                                                                     924  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ALLERGY TEST  | 
                                                            
| 
                                                                     468  | 
                                                                
                                                                     925  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PREG TEST  | 
                                                            
| 
                                                                     469  | 
                                                                
                                                                     929  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ADDITIONAL DX SVS  | 
                                                            
| 
                                                                     470  | 
                                                                
                                                                     931  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Rehab Day Prog, Half Day  | 
                                                            
| 
                                                                     471  | 
                                                                
                                                                     932  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Rehab Day Prog, Full Day  | 
                                                            
| 
                                                                     472  | 
                                                                
                                                                     940  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER RX SVS  | 
                                                            
| 
                                                                     473  | 
                                                                
                                                                     941  | 
                                                                
                                                                     N  | 
                                                                
                                                                     RECREATION RX  | 
                                                            
| 
                                                                     474  | 
                                                                
                                                                     942  | 
                                                                
                                                                     N  | 
                                                                
                                                                     EDUC/TRAINING  | 
                                                            
| 
                                                                     475  | 
                                                                
                                                                     943  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CARDIAC REHABILITATION  | 
                                                            
| 
                                                                     476  | 
                                                                
                                                                     944  | 
                                                                
                                                                     N  | 
                                                                
                                                                     DRUG REHAB  | 
                                                            
| 
                                                                     477  | 
                                                                
                                                                     945  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ALCOHOL REHAB  | 
                                                            
| 
                                                                     478  | 
                                                                
                                                                     946  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CMPLX MED EQUIP-ROUT  | 
                                                            
| 
                                                                     479  | 
                                                                
                                                                     947  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CMPLX MED EQUIP-ANC  | 
                                                            
| 
                                                                     480  | 
                                                                
                                                                     949  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ADDITIONAL RX SVS  | 
                                                            
| 
                                                                     481  | 
                                                                
                                                                     950  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Reserved  | 
                                                            
| 
                                                                     482  | 
                                                                
                                                                     951  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Athletic Training  | 
                                                            
| 
                                                                     483  | 
                                                                
                                                                     952  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Kinesiotherapy  | 
                                                            
| 
                                                                     484  | 
                                                                
                                                                     960  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE  | 
                                                            
| 
                                                                     485  | 
                                                                
                                                                     961  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/PSYCH  | 
                                                            
| 
                                                                     486  | 
                                                                
                                                                     962  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/EYE  | 
                                                            
| 
                                                                     487  | 
                                                                
                                                                     963  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/ANES MD  | 
                                                            
| 
                                                                     488  | 
                                                                
                                                                     964  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/ANES CRNA  | 
                                                            
| 
                                                                     489  | 
                                                                
                                                                     969  | 
                                                                
                                                                     N  | 
                                                                
                                                                     OTHER PRO FEE  | 
                                                            
| 
                                                                     490  | 
                                                                
                                                                     970  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Pro Fees, General  | 
                                                            
| 
                                                                     491  | 
                                                                
                                                                     971  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/LAB  | 
                                                            
| 
                                                                     492  | 
                                                                
                                                                     972  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/RAD/DX  | 
                                                            
| 
                                                                     493  | 
                                                                
                                                                     973  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/RAD/RX  | 
                                                            
| 
                                                                     494  | 
                                                                
                                                                     974  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/NUC MED  | 
                                                            
| 
                                                                     495  | 
                                                                
                                                                     975  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/OR  | 
                                                            
| 
                                                                     496  | 
                                                                
                                                                     976  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/RESPIR  | 
                                                            
| 
                                                                     497  | 
                                                                
                                                                     977  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/PHYSI  | 
                                                            
| 
                                                                     498  | 
                                                                
                                                                     978  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/OCCUPA  | 
                                                            
| 
                                                                     499  | 
                                                                
                                                                     979  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/SPEECH  | 
                                                            
| 
                                                                     500  | 
                                                                
                                                                     980  | 
                                                                
                                                                     N  | 
                                                                
                                                                     Pro Fees, General  | 
                                                            
| 
                                                                     501  | 
                                                                
                                                                     981  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/ER  | 
                                                            
| 
                                                                     502  | 
                                                                
                                                                     982  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/OUTPT  | 
                                                            
| 
                                                                     503  | 
                                                                
                                                                     983  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/CLINIC  | 
                                                            
| 
                                                                     504  | 
                                                                
                                                                     984  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/SOC SVC  | 
                                                            
| 
                                                                     505  | 
                                                                
                                                                     985  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/EKG  | 
                                                            
| 
                                                                     506  | 
                                                                
                                                                     986  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/EEG  | 
                                                            
| 
                                                                     507  | 
                                                                
                                                                     987  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/HOS VIS  | 
                                                            
| 
                                                                     508  | 
                                                                
                                                                     988  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PRO FEE/CONSULT  | 
                                                            
| 
                                                                     509  | 
                                                                
                                                                     989  | 
                                                                
                                                                     N  | 
                                                                
                                                                     FEE/PVT NURSE  | 
                                                            
| 
                                                                     510  | 
                                                                
                                                                     990  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PT CONVENIENCE  | 
                                                            
| 
                                                                     511  | 
                                                                
                                                                     991  | 
                                                                
                                                                     N  | 
                                                                
                                                                     CAFETERIA  | 
                                                            
| 
                                                                     512  | 
                                                                
                                                                     992  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LINEN  | 
                                                            
| 
                                                                     513  | 
                                                                
                                                                     993  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TELEPHONE  | 
                                                            
| 
                                                                     514  | 
                                                                
                                                                     994  | 
                                                                
                                                                     N  | 
                                                                
                                                                     TV/RADIO  | 
                                                            
| 
                                                                     515  | 
                                                                
                                                                     995  | 
                                                                
                                                                     N  | 
                                                                
                                                                     NONPT ROOM RENT  | 
                                                            
| 
                                                                     516  | 
                                                                
                                                                     996  | 
                                                                
                                                                     N  | 
                                                                
                                                                     LATE DISCHARGE  | 
                                                            
| 
                                                                     517  | 
                                                                
                                                                     997  | 
                                                                
                                                                     N  | 
                                                                
                                                                     ADMIT KITS  | 
                                                            
| 
                                                                     518  | 
                                                                
                                                                     998  | 
                                                                
                                                                     N  | 
                                                                
                                                                     BARBER/BEAUTY  | 
                                                            
| 
                                                                     519  | 
                                                                
                                                                     999  | 
                                                                
                                                                     N  | 
                                                                
                                                                     PT CONVENCE/OTH  |